AF Association
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Long term effects

Since being prescribed flecainide bisoprolol and apixaban I have had 12 months paf free, I do wonder if there are any known long term problems taking these drugs?

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I think it depends what you mean by long term. NOACs such as apixaban have only been around about ten years which to somebody my age is nothing. Many of us expect to be on anti-coagulation for life, however, in my case good old fashioned warfarin. So long as any drugs are monitored (some require regular eg annual blood tests for liver or kidney function) there seems little risk.

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Thankyou for your reply bob, I do have annual blood tests so that has put my mind at rest.

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Hi Denise :-) medication affects people different, no two of us are made exactly the same are we so some people will develop side effects to any medication while others have none.

I worry about taking any medication long term but ask myself ' Are there any known long term problems if I don't take these drugs'. I already know the answer to that question and that helps to make taking the medication less of a concern :-)

Unfortunately some of us have to take long term medication if we want to have a quality of life regardless of the long term consequences . I try not to worry what might happen long term and enjoying each day I feel well.

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Hi doodle 68, thankyou for your response, I appreciate the way this medication has improved my life but I suffer from terrible joint pain that an orthopaedic consultant attributed to statins, the damage is irreversible and therefore I'm always a bit concerned about anything I need to take.

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Orthopaedic consultant told me that 'any drug' can cause joint pain. In my case Statins gave me muscle pain and warfarin pain in weight bearing joints when walking and standing.

Neighbour on warfarin can cycle without pain as it is a different movement.

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Thanks seasider18, well they are keeping my af at bay so all is good at the moment

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Have you tried taking CoQ10, along with a good multi-vitamin-and-mineral from a health food shop, and possibly a small amount of fish oil, to see if they will help with the pain in the joints originally caused by statins?

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Thankyou for your response, I can't take fish oil, shame because it was great for my mum but will certainly look into others

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For all medication which I or my husband are supposed o use I always google for side effects and carefully read enclosed information.

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Drugs.com is a helpful site.

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Cheers I'll take a look

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Thankyou arvino agree and always read the enclosed information but I will take a look to see what I can find on the Internet as well

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I've been taking Apixaban, Bisoprolol and Flecainide for over 3 years and have read up on the possible side effects - goodness, what a compendium of possibilities! Every ailment known to medicine is listed.

The point is that no drug is completely side effect-free and no two people react in the same way to the same drug dose - and hopefully no-one on the planet will have every side effect listed!

For me, the effects of uncontrolled AF, SVT, AFlutter and other mad rhythms is much worse than the possibility of problems. I have had no AF in over 3 years and see my cardiologist every 6 months when he checks if Flecainide has changed my ECG trace.

At the beginning I too worried about side effects - which some posters have reported but have researched and considered and have decided to stick with the drugs whilst they work. I was very heartened recently to read a post from someone who has taken Flecainide for 15 years.

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Thankyou Finvola very reassuring to know

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I delayed taking amiodarone for AF for 8 months because of risk of side effects but finally did it. It worked amazingly well for 5 years before giving me hyperthyroiditis and I had to stop. Luckily the hyperthyroiditis is reversible but now I'm left with AF, considering other options.

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I absolutely loved my 50 mg twice a day flecainide I took for a 7 month afib free (no cardioversions!) but then when the EP Dr did a stress test😓I failed it going into Vtach which he said was caused by the flecainide. I begged him to allow me to continue the drug, he said it was not worth dying for, he said he had rather see afib instead of Vtach, which can instantly be deadly. I see so many do well on it, as I did also. Great drug I think.

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Sorry to hear that, did they give you an alternative?

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How horrible for you - did your EP suspect something or was this a routine stress test? I know some people cannot take Flecainide for the reason you state as it has the potential to organise the AF signals into something much worse. Full marks to your EP.

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That does sound promising. I was taken into hospital 11 times by ambulance with fast running (241 at lowest) and irregular heartbeat hence diagnosed with Afib. Eventually I was put on flecainide, together with the tablets I was already on and immediately I felt better. I had even had a cardioversion which was successful but due to hospital error the arrhythmia returned. Eventually had an ablation but have still been on the flecainide so couldn't tell if it had worked. Now my consultant wants me to stop the flecainide and I have gradually been cutting down and this week I feel awful. Palpitations have returned (although not the awful fast irregular beating which I'm frightened), I feel tired and short of breath. I felt so much better with the flecainide and I don't know why the consultant wanted me to come off them. Any ideas anyone. Consultant away for the summer so can't ask him.

Thank you

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I do not know if there are any long term affects with Bisoprolol fumarate, the beta blocker.Are you taking all three you mention.

I was only on it at the begining of the AF and they then took me off it and put me on to Diltiazem a calcium channel blocker, whatever that is, with the Digoxin. This did not improve the situation and after many months they gave me a cardiversion whilst at the same time as starting me on Amiaderone which suits me very well.The cardioversion was a success putting the heart back into sinus rythm.The other medications did not agree with me and they stopped them, one immediately and the other after some months so far as I can recall

I think they must put you on these medicines to see how you get on and if not successful after a very long time in my case, move you on to something else. I my case the cardioversion.I avoid alcohol and too much caffine so as not to upset the Amiaderone which keeps the heart beating in sinus rythm. Though no one has ever told me to avoid these.It is just common sense.

But to answer your question, the Bisoprolol they started me on was a very high dose which they had to reduce because of the bad effect it was having.My suspicion is that if you can take these medications and you evidently feel OK, then you can continue to take them.Your GP or your consultant would be able to reassure you about any long term effects, but there probably aren't any although you may need to be checked from time to time, but you would have been told this if it was necessary. Ask your GP if it is necessary to have checks.I have to have my liver and thyroid checked every 6 months.

So far as advice is concerned when I asked this forum if they knew whether it was OK to take the Amiaderone for any length of time, various respondents said 'definitely not' Then another person responded to say her Mother had been on it for 20 years with no ill effects and her uncle had been on it for 15 years.I think it is all down to whether they suit you or not and your GP/consultant are the best people to ask.I asked mine and he did not think there was any problem in my taking it.The scenario of coming off it would be much worse if the heart started fibrilating again. I think more harm is done worrying about these things, but fully understand it is not easy to stop worrying. But I have now stopped.

Best wishes.

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Thankyou for your response, I'm so pleased your treatment works, I'm trying to reduce the bisoprolol as I also take 2 other bp pills, I also avoid triggers, caffeine is the worst but also anything spicy or sweet, will try not to worry so much, as that's a trigger too!

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My Dr gradually reduced my amiodarone dose as much as he deemed reasonable, which for me was 200 mg on alternate days.

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I'm hoping to reduce doses, every bit helps

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My Ep would not put me on Amiorderone because he said I was too young with the long term posdible damage to lungs/thyroid. He said a short term drug or last resort. I really do not know, guess some do ok.

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Thanks. That is interesting. It may indeed be a drug of last resort. Perhaps it is not suitable for younger people.The parting shot from my cardiologist when he signed me off was that the Amiaderone could stop working at any time.Why he told me this is anybodys guess. When someone on this forum told me their mother had been on it for 20 years and an uncle for 15 years?As I said and you intimated some are OK.

Does your medication work? What are you taking?

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Well prior to paf just bp pill ramprimil now I take: apixaban flecainide bisoprolol, Co amnilifruse, rosuvastatin as well. Which is why I'm thinking about being prepared for long term effects. But still preferable to paf

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Thanks Denise for this which is broadening my understanding. Are you reducing the Bisoprolol with the support of your GP?

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Since July 11th and failing a stress test with the wondrous drug "flecainide"

I currently am not on any antiarrhytmic, only rate control and blood thinner. Metoprolol 50 mg twice a day and warfarin 5 mg a day. I have had 2 cardio versions since being off flecainide. One on Aug 20th and another on Aug 31st. I also have a dual pacemaker. I am thinking on ablation possibly, but I am going to see if I can get along better. Guess we will see.....I am not excited about a ablation.

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Thanks for outlining your treatment .Is this all on the NHS? Seems very efficient, so you seem to be being well looked after.Learning about these different medications from Denise and yourself is widening my understanding of these matters.

Why did you stop the Flecaiinide?

How does a double pacemaker differ from an 'ordinary' one?

Hope all goes well for you

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A dual pacemaker has one lead into the right atrium and one into the right ventrical. My EP took me off of the flecainide after me failing a stress test within 5 minutes, I had gone into Vtach ( heart rate was dropping instead of going up) he said it was caused by the drug😪I did not want off of it because it worked so well for my persistant afib.

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Thank you and best wishes in your endeavours to find a solution with your EP and the possible use of an ablation. I too would be a little dubious about it because to my simple mind it must be very tricky getting the right receptor burnt to prevent the mis firing of the heart. But having said that I really don't know.Thanks again.

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That's really helpful, thankyou spoiler

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Yes, my medication works. I am taking Flecainide 50 mg every 12 hours.

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I am only on metoprolol 50 mg twice daily ( rate control) blood thinner warfarin 5 mg daily. No, it has worked very well. Two cardioversions since July 11th. One Aug 20, another the 31st. So far this month ok, in NSR for now. We will see, praying.... options are slim except for trying ablation.

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Really want to avoid that, thanks for the response

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I am 64, have Lone PAF and have taken Flecainide only 100mgs x2 per day for 3+ years and with no side effects.

However, I think you need lots of luck and optimism if you think taking any powerful drug will have no effect on such a fine machine as the body. I have been working hard on lifestyle, supplements and diet to reduce the dose as soon as I can i.e. when everything else is absolutely fine and with my cardiologist's approval and only very very slowly.

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Totally agree!

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Hi secondtry, I was taking one bp tablet now take 11 a day since being diagnosed with paf 2 years ago. I agree with you and am trying to reduce my bisoprolol at the moment thankyou for your response

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I have tried all of the drugs mentioned but sadly unable to take any of them due to side effects. I was on Flecanide for 9 years and bisopropil for 18 months.

As previous posts say,everyone is different,just because I have not been able to continue with these drugs doesn’t mean you can’t. Be happy if they work for you

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